Full-mouth ultrasonic debridement and risk of disease recurrence:: a 1-year follow-up

Aim: To evaluate the incidence of disease recurrence following a full-mouth pocket/root debridement approach with ultrasonic instrumentation versus that following a traditional approach of quadrant-wise scaling and root planing (Q-SRP) performed with hand instrumentation. Methods: Thirty-seven patients were re-examined 1 year after the completion of a 6-month clinical trial comparing two different treatment protocols: a 1-h session of full-mouth ultrasonic debridement (UD - 19 patients) or four sessions of Q-SRP with hand instruments (Q-SRP - 18 patients). At 3 months, re-instrumentation was performed of pockets showing a remaining probing pocket depth (PPD) of >= 5 mm using the same type of instruments as used during the initial treatment phase. The clinical examinations comprised assessments of plaque, bleeding on probing (BoP) and PPD. The primary outcome variable was the incidence of recurrent diseased sites (i.e., sites showing PPD >= 5 mm and BoP+) between the post-treatment and 1-year follow-up examinations. All sites that were healed (PPD <= 4 mm and BoP-) at the post-treatment examination were included in the study sample, with a mean number of sites per patient of 23.5. Results: In the UD group, 29 (7%) out of 430 initially healed sites showed disease recurrence at the 1-year follow-up examination compared with 47 (11%) of 440 sites in the Q-SRP group (p > 0.05). Twelve patients (63%) in the UD group presented recurrent diseased pockets, compared with 14 patients (78%) in the Q-SRP group. Two or more recurrent, diseased pockets were observed in nine patients in the UD group versus 11 in the Q-SRP group. All but one of the smokers belonged to the group of patients presenting recurrences. A tendency towards a higher mean plaque score was observed for the patients with recurrent sites. Conclusion: The study revealed no significant difference in the incidence of recurrence of diseased periodontal pockets between the full-mouth UD approach and the traditional approach of Q-SRP.